OMEPRAZOLE-TETRACYCLINE COMBINATIONS ARE INADEQUATE AS THERAPY FOR HELICOBACTER-PYLORI INFECTION

Background: Current triple antimicrobial therapies cure Helicobacter p ylori infection in 60-90% of cases but are cumbersome. Addition of ome prazole to amoxycillin has been shown to enhance effectiveness when co mpared to amoxycillin alone. Method: We studied omeprazole 20 mg t.d.s . plus tetracycline 500 mg q.d.s. for 14 days (OMP/TCN) and omeprazole 40 mg in the morning plus tetracycline 500 mg q.d.s. along with bismu th subsalicylate tablets 2 q.d.s. (OMP/TCN/BSS) for 14 days. Forty-fou r patients (19 OMP/TCN, 25 OMP/TCN/BSS) with H. pylori peptic ulcer di sease were studied. H. pylori status was evaluated at least 4 weeks af ter ending antimicrobial therapy. Results: In the OMP/TCN group cure o f H. pylori infection was achieved in 5/19 (26%). Adding bismuth to th e regimen improved the results; 4 weeks after ending therapy cure of H . pylori infection was achieved in 12/25 (48%). Conclusions: Neither r egimen can be recommended for routine cure of H. pylori infection. Alt hough one cannot predict which antimicrobial therapies will be enhance d by the addition of omeprazole, these data suggest that future studie s should evaluate drugs whose effectiveness is compromised by low pH.